Variation in bone response to the placement of percutaneous osseointegrated endoprostheses: A 24-month follow-up in sheep

Autoři:
Sujee Jeyapalina aff001; James Peter Beck aff001; Alex Drew aff004; Roy D. Bloebaum aff003; Kent N. Bachus aff001
Působiště autorů:
Research, Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States of America
aff001; Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, The University of Utah, Salt Lake City, Utah, United States of America
aff002; Department of Orthopaedics, University of Utah Orthopaedic Center, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
aff003; Department of Bioengineering, University of Utah College of Engineering, The University of Utah, Salt Lake City, Utah, United States of America
aff004; Orthopaedic Research Laboratories, Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
aff005; Bone and Joint Research Laboratory, Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States of America
aff006
Vyšlo v časopise:
PLoS ONE 14(10)
Kategorie:
Research Article
doi: 10.1371/journal.pone.0221850

Souhrn

Percutaneous osseointegrated (OI) devices for amputees are metallic endoprostheses, that are surgically implanted into the residual stump bone and protrude through the skin, allowing attachment of an exoprosthetic limb. In contrast to standard socket suspension systems, these percutaneous OI devices provide superior attachment platforms for artificial limbs. However, bone adaptation, which includes atrophy and/or hypertrophy along the extent of the host bone-endoprosthetic interface, is seen clinically and depends upon where along the bone the device ultimately transfers loading forces to the skeletal system. The goal of this study was to determine if a percutaneous OI device, designed with a porous coated distal region and an end-loading collar, could promote and maintain stable bone attachment. A total of eight, 18 to 24-month old, mixed-breed sheep were surgically implanted with a percutaneous OI device. For 24-months, the animals were allowed to bear weight as tolerated and were monitored for signs of bone remodelling. At necropsy, the endoprosthesis and the surrounding tissues were harvested, radiographically imaged, and histomorphometrically analyzed to determine the periprosthetic bone adaptation in five animals. Bone growth into the porous coating was achieved in all five animals. Serial radiographic data showed stress-shielding related bone adaptation occurs based on the placement of the endoprosthetic stem. When collar placement and achieved end-bearing against the transected bone, distal bone conservation/hypertrophy was observed. The results supported the use of a distally loading and distally porous coated percutaneous OI device to achieve distal host bone maintenance.